Preparing for Pregnancy

Preparing for Pregnancy2019-02-14T16:06:48+00:00

Would you like to become pregnant in the next 12 months?™

Yes

Talk with your Rheumatologist about each step below.

To have the safest pregnancy possible:

  • use medications on the GO LIST
  • keep your lupus activity as low as possible for you

Having very active lupus during pregnancy puts you and your baby at higher risk for pregnancy loss and preterm delivery.

Work with your rheumatologist to answer these questions.

  • Minimal signs of inflammation
  • Minimal urine protein
  • No flare requiring prednisone in last 6 months
  • Check for Ro/SSA or antiphospholipid antibodies
  • Rheumatologist
  • Nephrologist
  • Maternal-Fetal
  • Cardiologist
  • Medicine Specialist
  • Pulmonologist
  • Local Obstetrician
  • Hematologist
  • Continue or start GO LIST medications
  • Stop STOP LIST medications (if needed, switch to a GO LIST medication)
  • Start a daily prenatal vitamin now
  • Start aspirin, 81mg per day, at the end of your 1st trimester
  • Discuss any other medications with your obstetrician

If

Else

Antiphospholipid
Syndrome

  • Take low molecular weight heparin and aspirin daily 81 mg/day

Ro/SSA antibodies

  • Monitor fetal echocardiograms in the 2nd trimester for early signs of heart block

Hypertension
(high blood pressure):

  • Control with pregnancy-safe medications (NO Ace-inhibitors or Angiotensin Receptor Blockers)

Pain during pregnancy:

  • Take up to 1000 mg of acetaminophen 3 times per day
  • Discuss NSAIDs (e.g., ibuprofen, naproxen, etc.) with your obstetrician

The GO List

√ Pregnancy Compatible

  • Hydroxychloroquine (Plaquenil)
  • Chloroquine
  • Azathioprine (Imuran)
  • Cyclosporine (Neoral, Restasis)
  • Tacrolimus (Prograf)
  • Colchicine
  • Prednisone (use sparingly)

The CAUTION List

Insufficient Information

  • Rituximab
  • Belimumab

What to do if pregnant on a STOP or CAUTION medication – For Providers | For Patient

The STOP List*

X May Cause Birth Defects

  • Methotrexate
  • Mycophenolate (CellCept)
  • Mycophenolic acid (Myfortic)
  • Cyclophosphamide (Cytoxan)
  • Thalidomide (Thalomid)
  • Lenalidomide (Revlimid)
  • Leflunomide (doesn’t cause loss or birth defects if stopped and removed with cholestyramine)

*If currently pregnant, immediately stop STOP list medications and read: What to do if pregnant on a STOP or CAUTION medication – For Providers | For Patients

If planning pregnancy, talk with your doctor BEFORE you stop.

This educational activity is supported by an educational grant from GlaxoSmithKline.

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